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TVC Building Access Request Form Applicant Name SSID # by olliegoblue34


									                                TVC Building Access Request Form

Applicant Name:___________________________ SS/ID #______________________

TVC Department/Program:______________________________________

Affiliation:        Adjunct Faculty             Staff               Student              Other

Contact Information:

Telephone:                        Mobile:                           Email:

Building Name:                                 Key Requested:

Area/Location                     Serial #

Requested Period:

____Semester               ____Short-Term               ____Other:_______________________

Begin Date:                              End Date:

Periodic Key Check:

____Semester        ____Short-Term              ____Monthly ____Other:______________


TVC Department/Program Authorized Signature:________________________________

Applicant accepts the responsibility for the following conditions: 1. Maintain security of any keys
issued. 2. Reports the loss/theft of a key(s) to immediate supervisor, TVC Director’s Office, as well
as the UAF Police Department and, submit a new key request form for replacement and pay for lost
key. 3. Return all University keys, upon transfer/termination, to the UAF Facilities Services Lock

Applicant Signature/Date:________________________________________________

Authorized:      ____Yes    ____No By:_______________________ Date:__________
                                       TVC Director/Designee

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